Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGJin-Hai ¹ , ZHANGXing-Hua ² ,  DUXiao-Zheng ³ , ZHAOMin ¹ , BAOYing-Cun ¹ , SHANGJun-Fang ¹ , JIANGHua ¹ , YUANBo ² , TIANLiang ² , ZHUBo-Wen ²

1. Department of Traditional Chinese Medicine, Second Hospital of Lanzhou University, Lanzhou 730000, China;
2. School of Acupuncture and Massage, Gansu College of Traditional Chinese Medicine, Lanzhou 73000, China;
3. School of Medical Technology, Gansu College of Traditional Chinese Medicine, Lanzhou 730000, China;

Corresponding?author：

DUXiao-Zheng, Email: lz-duxiaozheng@163.com

Keywords：

Ischemic stroke; Scalp acupuncture; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20150193

Video：

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Objective To systematically review the effectiveness of scalp acupuncture for treating ischemic stroke. Method We searched databases including PubMed, EMbase, MEDLINE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from inception to December 30th 2014 for randomized controlled trials (RCTs) on scalp acupuncture in the treatment of ischemic stroke. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 27 studies involving 2 741 patients were included. The results of meta-analysis showed that:a) As for the improvement of nervous functional deficiency, the scalp acupuncture plus drug group was superior to the drug alone group (MD=-5.33, 95%CI -6.71 to -3.96, P<0.000 01), and the scalp acupuncture plus conventional therapy group was superior to the conventional therapy alone group (MD=-2.11, 95%CI -3.31 to -0.91, P=0.0006). b) As for the effective rate, the scalp acupuncture group was superior to the body acupuncture group (OR=0.28, 95%CI 0.15 to 0.53, P<0.000 01), the scalp acupuncture plus drug group was superior to the drug alone group (OR=0.20, 95%CI 0.14 to 0.29, P<0.000 01), and the scalp acupuncture plus conventional therapy group was superior to the conventional therapy alone group (OR=0.12, 95% CI 0.02 to 0.56, P=0.008). However, there was no significant difference between the scalp acupuncture group and the drug alone group (OR=0.16, 95%CI 0.03 to 0.97, P=0.05). Conclusion Scalp acupuncture appears to be an effective adjuvant therapy method for ischemic stroke, and can significantly improve the nervous functional deficiency when combined with other treatment. However, the strength of evidence is low due to high risk of bias of the included studies. More rigorous studies are needed to verify the above conclusion.

Citation： WANGJin-Hai, ZHANGXing-Hua, DUXiao-Zheng, ZHAOMin, BAOYing-Cun, SHANGJun-Fang, JIANGHua, YUANBo, TIANLiang, ZHUBo-Wen. Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(10): 1161-1167. doi: 10.7507/1672-2531.20150193 Copy

1.	張子明. 中風臨床與康復. 北京:華夏出版社, 2007.
2.	徐紅君, 傅立新. 國內外缺血性卒中衛生經濟學評價研究. 中國現代神經疾病雜志, 2009, 9(5):430-433.
3.	李忠. 缺血性腦血管疾病. 北京:北京科學技術出版社, 2002.
4.	Pan S, Zhan X, Su X, et al. Proteomic analysis of serum proteins in acute ischemic stroke patients treated with acupuncture. Exp Biol Med (Maywood), 2011, 236(3):325-333.
5.	Hsing WT, Imamura M, Weaver K, et al. Clinical effects of scalp electrical acupuncturein stroke:a sham-controlled randomized clinical trial. J Altern Complement Med, 2012, 18(4):341-346.
6.	劉靈光, 張紅星. 神經干細胞在頭針治療缺血性腦卒中研究的意義. 針刺研究, 2007, 32(4):277-280.
7.	Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
8.	肖曉華, 李瑞春, 朱紅霞, 等. 頭穴透刺電針治療缺血性中風臨床觀察. 上海針灸雜志, 2008, 27(6):6-8.
9.	任素蓮, 秦峰玲, 武梅. 頭針治療缺血性中風后遺癥療效觀察. 長治醫學院學報, 2012, 26(1):59-61.
10.	Li YK, Chen XJ. Study on scalp electro-acupuncture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients apoplexy patients. World J Acup-Mox, 2001, 11(4):18-22.
11.	王萍. 頭針治療中風200例臨床觀察. 針灸臨床雜志, 2006, 22(12):54-55.
12.	王金海, 杜小正, 趙敏, 等. 頭穴透刺對缺血性中風病患者平衡功能影響的臨床研究. 江西中醫學院學報, 2013, 25(2):40-42.
13.	張學鑒. 頭針療法治療腦梗塞的臨床觀察中國康復醫學雜志, 1995, 10(2):85-86.
14.	丁建江, 張磊. 頭穴透刺治療腦梗塞及對血漿中β-內啡肽含量的影響. 時珍國醫國藥, 2007, 18(10):2535-2536.
15.	吳緒平, 楊毅紅, 李家康, 等. 頭穴透刺治療急性腦梗塞及對血漿中β-內啡肽含量的影響. 中國針灸, 2000, (1):429-431.
16.	建江, 張磊. 頭穴透刺治療腦梗塞及對血漿中β-內啡肽含量的影響. 時珍國醫國藥, 2007, 18(10):2535-2536.
17.	王國書, 俞昌德, 李昌生, 等. 頭針配合藥物對急性腦梗死患者血清MDA的影響. 上海針灸雜志, 2009, 28(3):135-137.
18.	蔡敬宙, 潘錦瑤. 頭針與腦梗塞后血管的早期再通. 上海針灸雜志, 2002, 21(4):9-10.
19.	孫世曉, 張秀花, 徐博佳. 頭針治療對急性腦梗塞S100B蛋白影響及臨床療效觀察. 針灸臨床雜志, 2005, 21(1):20-21.
20.	Bao CL, Huang XJ, Zhang LR, et al. Influence of Scalp Point-to-point Acupuncture on serum sICAMI in patients with acute cerebral infarctio. J Acupunct Tuina Sci, 2006, 4(4):213-214.
21.	韓艦華. 頭皮針治療急性缺血性中風120例療效觀察. 上海針灸雜志, 2004, 23(8):14-15.
22.	焦青峰. 頭針配合脈絡寧治療腦梗死近期療效觀察. 實用醫技雜志, 2006, 13(23):4212-4213.
23.	劉寧, 馬國慶, 閆子生. 頭針叢刺長留針治療缺血性腦梗塞的臨床觀察. 針灸臨床雜志, 2001, 17(3):31.
24.	劉建峰. 頭針治療急性腦梗死的療效觀察. 山西醫藥雜志, 2007, 36(2):961.
25.	任彥紅, 王岱, 馮春祥. 頭皮針提插動流綜合手法治療缺血性中風偏癱臨床對比研究. 中醫雜志, 1997, 38(8):475-476.
26.	任素蓮, 施曉瑜, 李莉. 頭針配合血塞通治療腦梗死110例療效觀察. 長治醫學院學報, 2011, 25(1):57-59.
27.	王光義, 蔣乃昌, 賀志光. 頭針對腦梗塞患者血漿ET-1、MDA、NO的影響. 中國針灸, 2001, 21(4):241-242.
28.	王煥英. 頭針配合補陽還五湯治療腦梗塞80例. 陜西中醫, 2003, 24(2):165.
29.	吳芙蓉. 頭穴透刺治療急性腦梗死對血漿中β-內啡肽濃度的影響. 中國康復, 2009, 24(6):396.
30.	徐會彬, 周剛鑫, 李耐平, 等. 銀杏達莫靜滴聯合頭針治療急性腦梗死. 臨床和實驗醫學雜志, 2007, 6(8):140-141.
31.	楊富強. 頭針治療急性缺血性卒中120例. 中國實用神經疾病雜志, 2009, 12(11):58-59.
32.	謝冬玲, 朱麗芳, 劉惠宇, 等. 事件相關電位P300在頭皮針治療康復期腦梗死認知障礙應用. 上海針灸雜志, 2010, 29(3):152-153.
33.	俞昌德, 吳炳煌, 洪安輝, 等. 頭針加藥物治療早期腦梗塞患者的療效觀察. 中國針灸, 2003, 23(2):67-69.
34.	張德祥, 王曉彤, 周佰玲. 頭針配合康復訓練治療老年缺血性腦卒中療效觀察. 上海針灸雜志, 2013, 32(3):164-166.
35.	舒相平. 急性腦梗死在針灸治療中臨床療效觀察. 中外醫療, 2011, 30(34):10-11.
36.	張紅星. 頭針對中風病患者血液流變性、血脂、載脂蛋白的影響. 中國中醫急癥, 2003, 12(5):409.
37.	代杰, 項容, 陳勇, 等. 頭針結合康復治療急性腦梗死的最佳時間窗研究. 現代中西醫結合雜志, 2014, 23(13):1381-1383.

1. 張子明. 中風臨床與康復. 北京:華夏出版社, 2007.
2. 徐紅君, 傅立新. 國內外缺血性卒中衛生經濟學評價研究. 中國現代神經疾病雜志, 2009, 9(5):430-433.
3. 李忠. 缺血性腦血管疾病. 北京:北京科學技術出版社, 2002.
4. Pan S, Zhan X, Su X, et al. Proteomic analysis of serum proteins in acute ischemic stroke patients treated with acupuncture. Exp Biol Med (Maywood), 2011, 236(3):325-333.
5. Hsing WT, Imamura M, Weaver K, et al. Clinical effects of scalp electrical acupuncturein stroke:a sham-controlled randomized clinical trial. J Altern Complement Med, 2012, 18(4):341-346.
6. 劉靈光, 張紅星. 神經干細胞在頭針治療缺血性腦卒中研究的意義. 針刺研究, 2007, 32(4):277-280.
7. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
8. 肖曉華, 李瑞春, 朱紅霞, 等. 頭穴透刺電針治療缺血性中風臨床觀察. 上海針灸雜志, 2008, 27(6):6-8.
9. 任素蓮, 秦峰玲, 武梅. 頭針治療缺血性中風后遺癥療效觀察. 長治醫學院學報, 2012, 26(1):59-61.
10. Li YK, Chen XJ. Study on scalp electro-acupuncture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients apoplexy patients. World J Acup-Mox, 2001, 11(4):18-22.
11. 王萍. 頭針治療中風200例臨床觀察. 針灸臨床雜志, 2006, 22(12):54-55.
12. 王金海, 杜小正, 趙敏, 等. 頭穴透刺對缺血性中風病患者平衡功能影響的臨床研究. 江西中醫學院學報, 2013, 25(2):40-42.
13. 張學鑒. 頭針療法治療腦梗塞的臨床觀察中國康復醫學雜志, 1995, 10(2):85-86.
14. 丁建江, 張磊. 頭穴透刺治療腦梗塞及對血漿中β-內啡肽含量的影響. 時珍國醫國藥, 2007, 18(10):2535-2536.
15. 吳緒平, 楊毅紅, 李家康, 等. 頭穴透刺治療急性腦梗塞及對血漿中β-內啡肽含量的影響. 中國針灸, 2000, (1):429-431.
16. 建江, 張磊. 頭穴透刺治療腦梗塞及對血漿中β-內啡肽含量的影響. 時珍國醫國藥, 2007, 18(10):2535-2536.
17. 王國書, 俞昌德, 李昌生, 等. 頭針配合藥物對急性腦梗死患者血清MDA的影響. 上海針灸雜志, 2009, 28(3):135-137.
18. 蔡敬宙, 潘錦瑤. 頭針與腦梗塞后血管的早期再通. 上海針灸雜志, 2002, 21(4):9-10.
19. 孫世曉, 張秀花, 徐博佳. 頭針治療對急性腦梗塞S100B蛋白影響及臨床療效觀察. 針灸臨床雜志, 2005, 21(1):20-21.
20. Bao CL, Huang XJ, Zhang LR, et al. Influence of Scalp Point-to-point Acupuncture on serum sICAMI in patients with acute cerebral infarctio. J Acupunct Tuina Sci, 2006, 4(4):213-214.
21. 韓艦華. 頭皮針治療急性缺血性中風120例療效觀察. 上海針灸雜志, 2004, 23(8):14-15.
22. 焦青峰. 頭針配合脈絡寧治療腦梗死近期療效觀察. 實用醫技雜志, 2006, 13(23):4212-4213.
23. 劉寧, 馬國慶, 閆子生. 頭針叢刺長留針治療缺血性腦梗塞的臨床觀察. 針灸臨床雜志, 2001, 17(3):31.
24. 劉建峰. 頭針治療急性腦梗死的療效觀察. 山西醫藥雜志, 2007, 36(2):961.
25. 任彥紅, 王岱, 馮春祥. 頭皮針提插動流綜合手法治療缺血性中風偏癱臨床對比研究. 中醫雜志, 1997, 38(8):475-476.
26. 任素蓮, 施曉瑜, 李莉. 頭針配合血塞通治療腦梗死110例療效觀察. 長治醫學院學報, 2011, 25(1):57-59.
27. 王光義, 蔣乃昌, 賀志光. 頭針對腦梗塞患者血漿ET-1、MDA、NO的影響. 中國針灸, 2001, 21(4):241-242.
28. 王煥英. 頭針配合補陽還五湯治療腦梗塞80例. 陜西中醫, 2003, 24(2):165.
29. 吳芙蓉. 頭穴透刺治療急性腦梗死對血漿中β-內啡肽濃度的影響. 中國康復, 2009, 24(6):396.
30. 徐會彬, 周剛鑫, 李耐平, 等. 銀杏達莫靜滴聯合頭針治療急性腦梗死. 臨床和實驗醫學雜志, 2007, 6(8):140-141.
31. 楊富強. 頭針治療急性缺血性卒中120例. 中國實用神經疾病雜志, 2009, 12(11):58-59.
32. 謝冬玲, 朱麗芳, 劉惠宇, 等. 事件相關電位P300在頭皮針治療康復期腦梗死認知障礙應用. 上海針灸雜志, 2010, 29(3):152-153.
33. 俞昌德, 吳炳煌, 洪安輝, 等. 頭針加藥物治療早期腦梗塞患者的療效觀察. 中國針灸, 2003, 23(2):67-69.
34. 張德祥, 王曉彤, 周佰玲. 頭針配合康復訓練治療老年缺血性腦卒中療效觀察. 上海針灸雜志, 2013, 32(3):164-166.
35. 舒相平. 急性腦梗死在針灸治療中臨床療效觀察. 中外醫療, 2011, 30(34):10-11.
36. 張紅星. 頭針對中風病患者血液流變性、血脂、載脂蛋白的影響. 中國中醫急癥, 2003, 12(5):409.
37. 代杰, 項容, 陳勇, 等. 頭針結合康復治療急性腦梗死的最佳時間窗研究. 現代中西醫結合雜志, 2014, 23(13):1381-1383.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis

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